First Aid Information

This document is based upon Roger Koehler’s notes taken from the One10CPR training received on Sat, 3/25/2017 in Albuquerque, New Mexico.

Addl. information was added based upon supplemental training received from the Albuquerque Balloon Fiesta Organization on 5/20/19.

The full, updated CPR manual, including all updated information, can be found in the following PDF …

CPR and First Aid Certification PDF

 

Introduction

Deborah and I attended a 4 hour First Aid and CPR training class on March 25^th here in Albuquerque.  It is something that we had both been thinking about for some time.  Not that we expected to become experts or anything, but we wanted to at least become familiar with some of the basics.  I also put together this reference document based upon what we learned.

One thing that certainly became clear during the training was that being able to identify exactly what is happening if you came upon someone who was seemingly collapsed is an inexact science.

• Are they experiencing a heart attack, heat exhaustion, or a stroke?
• Are they just drunk and sleeping it off?
• Should you call 911 or offer assistance?

There are no easy answers. One thing we did learn is that although you are not required by law to provide assistance, once you begin to provide some assistance, such as giving CPR, you are required by law to continue until professionals arrive or until you become exhausted.

But as you will note by the Table of Contents for this document, a lot of first aid situations were covered in the class – not just providing CPR for a suspected heart attack.  We hope to be able to have this document available as a handy reference if/when we come up on various situations that might require first aid.

One thing that we have done, which we highly recommend, is to purchase a first aid kit and place one in each of our cars.  There are lots of different ones available on the internet, or even in stores like Walmart.  They vary typically by the kind and amount of supplies they contain.  Almost all contain the basics – various sizes of bandages, gauze, ointments, etc.  We chose one that has 100 pieces in it for $13.99/ea. off of Amazon.  A description of the one we purchased is in the Appendix at the end of this document.

We even looked into purchasing a portable defibrillator (AED – Automated External Defibrillator).  But even used, the least expensive we could find was about $700, and all new ones were over $1000.  So we passed on that although it certainly would be helpful to have on hand.  CPR is, after all, a temporary measure intended to be done until an AED becomes available – either from professionals or from other onlookers.

Reference Materials & Equipment Recommendation   

• Download the Red Cross App to your smart phone
• Get a first aid kid for each car
• Purchase an AED

When coming upon a person possibly requiring first aid

• C C C – CHECK , CALL, CARE
  • CHECK – Check the scene around the injured
    • Is it safe?
      • If not, only try to move the injured if in imminent addl. danger, such as fire, toxic chemicals, etc.
    • Check for any clues as to what may have happened
    • How many people are involved
    • Ask any bystanders for information
    • If victim is UNRESPONSIVE
      • Shout their name, tap them on the shoulder while check for normal breathing
        • Gasping is NOT normal breathing
      • If still not responsive, and not breathing
        • Send someone to call 911 and get an AED
        • Immediately begin CPR until an AED becomes available.
      • CALL – Call 911
        • If someone else is around, tell them to call “911”
          • Be sure to tell them to “COME BACK”
        • If not, administer initial first aid and call 911 as soon as possible.
        • Tell them to get an AED if one can be located
      • CARE – Provide care and assistance to the injured
        • Let the person know that you are CPR certified
        • If they are conscious, ask the injured for consent to assist them
          • If a child, ask an adult. If no adult is present, consent is assumed.
        • Do NOT give care unless consent is given … but call 911.
        • Once consent is given, if you begin CPR, you are required by law to continue until you are exhausted.
        • The Good Samaritan law protects you as long as consent is given.
      • Check the body of a responsive person
        • If there are no life-threatening symptoms (severe bleeding, gasping for air, etc) then …
          • Perform a head to toe body check
          • Interview the person while performing the check
          • Call 911 or have someone else call 911
        • Questions to ask when coming up on a person possibly requiring first aid
          • S A M P L E
            • S = Signs and Symptoms
            • A = Allergies
            • M = Medications
            • P = Pertinent Medical History
            • L = Last food and drink
            • E = Events leading up to what happened
          • Check for breathing
            • Gasping for breath is NOT considered breathing

 AED use (Automated External Defibrillator)

• Use as soon as one becomes available
• Perform CPR until one becomes available but use the AED as soon as it arrives
• Turn the AED on and then just follow the verbal prompts
  • It will walk you through the process
• Many AED kits have both adult and child pads
  • Child pads administer a lesser shock
  • You CAN use an adult pad on a child, but you canNOT use a child pad on an adult
• Before applying the pads, remove clothing from chest to expose skin, and dry the skin if necessary.
  • If an extremely hairy chested individual, the adhesive on the pads is quite strong. Apply to chest hair and then rip away.
• Positioning of pads
  • Adult
    • One above nipples on either side of chest
    • The other on the opposite side beneath the armpit
    • Pads must NOT be touching
  • Child – infant
    • One pad on chest
    • One pad on infant’s back
  • After pads are applied, the AED will analyze the victim
  • If AED says to deliver a shock
    • Make sure no one is touching the victim
      • Yell CLEAR
    • Push the “shock” button to deliver the shock
  • After delivering the shock, or if the AED does not recommend a shock
    • Continue CPR and following the AED’s directions until exhausted or EMS arrives on scene

Anaphylaxis – Allergic Reactions

• Check to see if they have a wrist bracelet with allergy info
• Typically the result of exposure to an allergen
  • Ex: peanuts
  • Ex: diabetic
• Symptoms
  • Skin reaction
  • Swelling of face, neck or tongue
  • Trouble breathing
• Care (treatment)
  • Care 1^st – then call 911
  • Ex: person has an epi-pen
    • If person is conscious, help them administer the epi-pen but do NOT do it yourself
    • Location of injection: outside the middle of one thigh
    • Pull off the safety cap on the injector
    • Have person hold the tip of the auto-injector at a 90 degree angle to the thigh
    • After injecting, massage the injection site for several seconds
    • Check the person’s response to the medication
    • Only help administer 2^nd dose if …
      • EMS personnel are delayed
      • Person is still having symptoms 5-10 minutes after 1^st dose
    • Ex: diabetic
      • Give candy, orange juice or something sweet

Bleeding

• Cover wound with sterile gauze and apply direct pressure to wound
• Use a gauze to stop/slow the bleeding
  • If gauze soaks through, apply another gauze on top
  • Do NOT remove the first gauze.
    • To do so, you would have to remove pressure and you risk exposing the wound to more infection.
  • Wrap a roller bandage around the gauze
    • Before you get to the end of the wrapping material …
  • Extend wrap out from the wound.
  • Place finger on top of wrap halfway between hand and wound.
  • Bring finger and wrap under wound to other side and then tie off above the wound.
  • Check for circulation beyond the point of the bleeding
    • Ex: bleeding on arm, check to see if the hand is discolored or cold to the touch; does the person have feeling
  • Apply a tourniquet
    • Use ONLY for severe, life-threatening bleeding such as loss of limb
    • Use a tourniquet from a kit if available

Breathing Emergencies – fainting, dizziness (not related to choking)

• Have the person sit down and lean forward
• Place head between the legs
• Breath into a paper bag

Burns

• S C C
• Stop – remove the person from the source of the burn
  • Ex: Thermal burn:  remove the source of the head
  • Ex: Chemical burn:  Remove contaminated clothing; flush area with cold water, brush chemical off
  • Ex: Electrical:  Turn off the power at its source.
    • Do NOT touch the person until the power is OFF.
  • Cool – apply cold water that is suitable for drinking for at least 10 minutes
    • Do NOT use river or sea water because of contaminants in the water
    • Do NOT apply ice; ice can do more damage
    • Don’t use anything that is too cold
  • Cover – use a sterile dressing and cover the burn loosely
    • Saran wrap works well
  • Questions to ask – victim, bystander before calling 911
    • What caused the burn?
    • How deep does the burn appear?
    • How much of the body is burned?
    • Where is the burn located?
  • Infants and elderly are often more critical to receive quick treatment
  • DON’T put butter or greasy stuff on the burn
  • Use a burn ointment if available

CPR Steps (Cardio Pulmonary Resuscitation)

• First verify that the person is not breathing (or only gasping)
• Lay person face-up, flat on the ground
  • If a small child, you may hold them firmly along the back and rest them on your knees while sitting down
• Alternate a sets of 30 chest compressions with 2 rescue breaths and repeat
  • Chest compressions
    • Use both hands on an adult or 2 fingers if a child
    • Position hands or fingers over the center of the chest
    • Position weight over your hands to help avoid fatigue
    • Push hard and fast (2 per second) to a depth of at least 2 inches
    • Count the compressions out loud so anyone assisting you knows how many have been delivered – including YOU
  • Rescue Breaths
    • Open the airway by tilting head slightly back
    • Pinch the nose shut and make a complete seal over the mouth
      • Use a breathable mask if you have one or place a porous covering over the mouth, such as a shirt
    • Blow into the person’s mouth for about 1 second ensuring that the chest rises
      • If chest does not rise when administering breaths, check the mouth
        • Use a sweeping motion to clear any debris
        • Do NOT push anything into the victim’s mouth
      • No more than two rescue breaths before returning to chest compressions
      • Breaths are now considered optional when providing CPR
        • For example, do NOT place anything between their teeth when using an AED. Victim might swallow it.

Cadiac Arrest  Symptoms

• Person is not responsive
• Person is not breathing
• Person has no heart beat

Cardiac Chain of Survival

1. Call 911 when you recognize the symptoms
2. Start CPR
3. If obtained, start defibrillation using an AED (Automated External Defibrillator)
   • (Steps 1-3 may be administrated by a non-professional)
4. Administer advanced medical assistance
5. Transport individual to a medical facility
   • (Steps 4-5 are administered by EMT’s)

 Choking (using the Heimlich Maneuver)

Important:  Look for the universal sign of choking – hand place on the throat.   Tell the person you are first aid certified and ask their permission to perform the Heimlich.

1. Bend victim over at the waist and administer 4-5 hard slaps with the palm of the hand between the shoulder blades.
   • This is intended to loosen any obstruction
   • Place one leg forward between the two legs of the victim with the other leg slightly back for balance
   • Place one arm in from of the victim under the arm and up to the opposite shoulder.
     1. This will provide good leverage to hold the person up should they start to fall forward.
   • Perform a Heimlich – abdominal thrusts
     1. If person is not too big to get your arms around
        1. Place 2 fingers on the person’s belly button
        2. Make a fist with the other hand and place it just above the 2 fingers.
2. Take the fingers off the belly button and place the hand firmly over the fist that was made with the other hand.
3. Make 5 rapid motions drawing the fist in and up
4. If person is too big
   • Place person up against a wall facing you
   • Position the hands above the belly button as indicated above and press forward in and up
5. After performing “2a” or 2b”, if person still cannot get their breath, repeat the back slaps and perform the Heimlich again
6. Continue alternating 5 back blows and 5 abdominal thrusts until person can cough forcefully or they become unresponsive
7. If unresponsive
   • Lower person to ground and begin CPR.
   • After each set of CPR, look in mouth and do a sweep to see if object has been dislodged.

Cold-related – Hypothermia

• Symptoms
  • If shivering STOPS, that is a problem.
    • Shivering is a normal response to cold.
  • Skin is discolored or even black
• Treatment
  • Warm up the victim gradually
    • Do NOT put them in a hot shower or sauna
  • Do NOT give them coffee or brandy
  • Do NOT massage any areas of frostbite

Head, Neck or Spine Injuries

• Symptoms
  • Bleeding from the ear
  • Nauseated
  • Forgetful
  • Dizzy
• Asking questions
  • Ask while facing the person so they do not have turn their head
  • Ask for a verbal response. Don’t make them shake their head.
• If wearing a helmet, do NOT remove
  • The helmet may inhibit swelling

Heart Attack  Symptoms

• Chest pain
  • May be mild or severe; resting or lying down does not help
• Appearance
  • Pale or gray skin
  • Sweating and/or dizziness
• Pain spreads to one or both arms
• Men often have more classic symptoms. Women sometimes have milder, less severe symptoms.

Heat-related (not burns)

• Symptoms & treatment
  • Cramps
    • Treatment
      • Give water, milk or a sports drink (w/electrolytes)
      • Massage the muscles
    • Exhaustion
      • Victim may have cool or moist skin
      • Treatment
        • Move to shaded area
        • Give water, milk or a sports drink
      • Heat stroke
        • May have loss of consciousness
        • Hot skin to touch
        • Rapid and shallow breathing
        • Treatment
          • Place person in a tub of cold water

Medications

• Ask person if they have medications to help, but you can only assist them with the medication.  You cannot administer  the medication yourself.
  • Examples
    • Person has an epi-pen for allergies
      • Hold the pen in the person’s hand and stab in the leg
    • Person has nitroglycerin pills for their heart
      • Help them place the pills in their own mouth

Muscle and Joint Injuries

• DON’T apply a split if a bone is protruding or if break is not clean
  • Ex: there is lots of swelling

Poisoning

• Symptoms
  • Check for any burns around the mouth or frothing
  • Check around area for any potential sources of the poisoning
  • Call 911 – not poison control
    • Poison control will just tell you to call 911 anyway.

Seizures

• #1 – Don’t put anything between their teeth. They might swallow it.
• Try to get person lying on the ground.
• Let the seizure take its course
• If seizures continue, call 911

Stroke

• F A S T
  • F – Face; look for drooping features.
    • Ask person to smile
  • A – Arms; ask person to try to raise both arms
    • See if one arm drifts downward or appears weak
  • S – Speech; has slurred or non-sensical speech
    • Ask person to repeat a simple phrase: “The sky is blue”
  • T – Time; note the time when the symptoms began
• Stay with person until EMS arrives
• Place person in the “recovery position”
  • Lying down on their side
  • One arm raised straight above their head
  • Legs slightly bent

Appendix

Certification

Personal First Aid Kit

We purchased two of these first aid kits off of Amazon for $13.99/ea., and keep one in each car.

This Deluxe 100 piece First Aid Kit first aid kit from Total Resources is a necessity for the workplace and meets or exceeds all OSHA / ANSI 2009 types I and II requirements for small business. It is in a hard carrying case designed with a multi-compartment organizer. It can be carried around for portability or mounted on a wall in a central location.

Supplies up to 10 people and is packed in a compact plastic case for easy storage and use.

This multi-purpose First Aid Kit includes:  

• 12 alcohol prep pads
• 12 antiseptic towelettes
• 1 first aid instruction guide
• 4 examination gloves
• 6 antibiotic ointment packets
• 6 burn cream packets
• 1 instant cold pack (5 inch x 6 inch)
• 16 adhesive bandages (1 inch x 3 inch)
• 25 adhesive bandages (3/4 inch x 3 inch)
• 2 non-adherent pad (2 inch x 3 inch)
• 1 paper tape roll (1/2 inch x 5 yard)
• 1 triangular bandage (40 inch x 40 inch x 56 inch)
• 4 sterile gauze pads (2 inch x 2 inch)
• 4 sterile gauze pads (3 inch x 3 inch)
• 4 sterile gauze pads (4 inch x 4 inch)
• 1 sterile trauma pad (5 inch x 9 inch)